Infectious disease was central to the response to COVID-19, but that visibility has not automatically translated into a robust training pipeline. In recent years a meaningful share of ID fellowship positions have gone unfilled in the Match.
The reasons are structural. Compensation for ID relative to the additional years of training compares unfavorably with many procedural specialties, and that math shapes career choices.
The stakes are real. ID physicians lead antimicrobial stewardship, manage complex infections, and stand up outbreak responses — work whose value is not fully captured by procedure-based payment.
Sustaining the field takes mentorship of trainees and sustained advocacy for reimbursement reform. The next generation of ID clinicians is not guaranteed; it has to be actively cultivated.